老年人胸片阴性肺结核临床分析

目的描述老年人胸片阴性肺结核的早期临床表现。方法分析1996年1月至1999年12月在莱芜市人民医院呼吸内科诊断明确的胸片正常老年肺结核病人临床资料。结果 12例病人通过痰培养检查确诊,其中3例同时痰涂片抗酸杆菌阳性;33%病人合并慢性阻塞性肺病,所有病人均有多种临床症状,以乏力、发热、咳嗽最常见;91%的病例表现为乏力〉2周和/或发热〉1周和/或咳嗽、咳嗽加重〉1月。结论对于不明原因的乏力〉2周、发热〉1周、咳嗽或咳嗽加重〉1月的老年人即使胸片阴性也应进行结核菌检查以排除肺结核可能。

The clinical characteristics of pulmonary tuberculosis in the aged with negative chest radiograph

Objective: To describe the early symptoms of pulmonary tuberculosis in the aged with negative chest radiograph.Methods: We reviewed the clinical materials of 12 aged pulmonary tuberculosis patients with negative chest radiograph that were hospitalized from Jan 1996 to Dec 1999 in Laiwu City Hospital.Results: Twelve cases were diagnosed by positive sputum-culture,and 3 of them were positive sputum-smear;33% of the patients were accompanied with COPD,and all of them had symptoms,the most common which were fatigue,fever,and cough,and 91% of the patients presented one or more of the followings: fatigue>2 weeks,fever>1 week,cough or cough exacerbation>1month.Conclusion: For the aged man even with a normal chest radiograph,a sputum smear or culture for a Mycobacterium tuberculosis is necessary in order to exclude the pulmonary tuberculosis in one the following conditions: fatigue >2 weeks,fever >1 week,cough or cough exacerbation > 1 month.